{"id":20809,"date":"2016-10-17T14:37:40","date_gmt":"2016-10-17T19:37:40","guid":{"rendered":"http:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/?p=20809"},"modified":"2022-03-11T11:43:17","modified_gmt":"2022-03-11T16:43:17","slug":"mitral-aortic-valve-replacement-fit","status":"publish","type":"post","link":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2016\/10\/17\/mitral-aortic-valve-replacement-fit\/","title":{"rendered":"Surgeon Q&#038;A: Can an Aortic Valve Replacement Fit in the Mitral Position?"},"content":{"rendered":"<p>I just received a great question from Dorothy about heart valve replacements. Dorothy asked me, &#8220;Hi Adam, Why can some of the newer valves, like the Perceval\u00a0and\u00a0<a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2016\/08\/09\/trifecta-gt-fda-approval\/\">Trifecta GT<\/a>, only be used in the aortic position and not the mitral? If those valves are new and good shouldn\u2019t they be used in the mitral position as well? I have moderate mitral stenosis. Thanks Adam!&#8221;<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20823 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/..\/Images\/Aortic-Mitral-Replacement-Farivar.jpg\" alt=\"aortic-mitral-replacement-farivar\" width=\"575\" height=\"301\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><!--more--><\/p>\n<p>To help Dorothy, I contacted <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Robert+Saeid-Farivar-Boise-Idaho.php\">Dr. Robert Saeid Farivar<\/a>. So you know, Dr. Farivar is a has performed successful surgery on many patients in our community including Tammi Gunwall, Julie Mcdonald-Lindgren and Rob Johnston.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/profileImages\/367_129_179.jpg\" alt=\"Dr. Robert Saeid Farivar\" width=\"129\" height=\"179\" \/>Dr. Robert Saeid Farivar<\/p>\n<p>&nbsp;<\/p>\n<p>In his response, Dr. Farivar shared three important reasons why mitral valve replacements are not used in the aortic valve position:<\/p>\n<p>&nbsp;<\/p>\n<blockquote><p>That is a great question Dorothy.\u00a0In theory, an aortic valve could be used in the mitral valve position by turning them upside down. In practicality, we don\u2019t do that for a couple of reasons:<\/p>\n<ul>\n<li>First, mitral valve openings are larger than aortic valve openings. So, the aortic valve is not wide enough.<\/li>\n<li>Second, the profile height of the valve is very important in the mitral position. We like to have a &#8220;low profile\u201d\u00a0mitral valve so that it does not obstruct the left ventricular outflow tract.<\/li>\n<li>Third, a valve like the Perceval is specifically designed to only sit in the aortic position since it is so &#8220;tall\u201d.<\/li>\n<\/ul>\n<\/blockquote>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/Images\/perceval-sutureless-valve-replacement.jpg\" alt=\"Perceval\" width=\"225\" height=\"166\" \/>Perceval Sutureless Heart Valve<\/p>\n<p>&nbsp;<\/p>\n<p>Then, Dr. Farivar addressed the impact of pressure on aortic valve performance and durability in the mitral valve position:<\/p>\n<p>&nbsp;<\/p>\n<blockquote><p>Another important fact for patients to know\u2026 The mitral and aortic valves have different pressure cycling. The aortic valve, for example, cycles between systolic and diastolic pressure (let\u2019s say 120 mm Hg and 80 mm Hg, thus a 40 mm Hg difference). The mitral valve cycles between systolic and diastolic pressure at essentially 0. That said, there is a higher cycling pressure in the aortic valve and therefore a greater tendency for the valve to &#8220;wear out\u201d.<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<p>Lastly, Dr. Farivar addresses a special congenital case in which aortic valves have been used in the mitral valve position:<\/p>\n<p>&nbsp;<\/p>\n<blockquote><p>In congenital cases, where we need a really small mitral valve, we have turned aortic mechanical valves upside down&#8230; but that is the only case.<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<p>Many thanks to Dorothy for her awesome question. Also, I would like to extend a special thanks to Dr. Farivar for sharing his clinical experience and research with our community!!!<\/p>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":20819,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[28],"tags":[],"class_list":["post-20809","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aortic-valve-replacement"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/20809","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/comments?post=20809"}],"version-history":[{"count":2,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/20809\/revisions"}],"predecessor-version":[{"id":34602,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/20809\/revisions\/34602"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media\/20819"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media?parent=20809"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/categories?post=20809"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/tags?post=20809"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}